Plugged Ducts

A plugged duct is caused when milk sits too long in a milk duct and creates a blockage. (Think of melted butter when it cools - it solidifies.) It feels like a sore spot on your breast, and can quickly turn into a major pain in the boob. Clear the blockage by getting milk moving through that spot again. 

If not cleared quickly enough, a plugged duct can become infected and turn into mastitis. Work to effectively clear your plugged duct as soon as you notice it so it doesn’t evolve into mastitis (trust us!). 

Symptoms

  • Pain in a specific spot on your breast. It can start out feeling like a bruised spot.

  • A lump can often be felt where the pain is (but sometimes not at first, if the clog is still small or buried deep within breast tissue)

Possible Causes

While plugged ducts are common, they aren’t “normal”. If you get a plugged duct, it’s because milk has sat in that milk duct for too long for some reason. It’s important to figure out why you got one, so you can take steps to keep this from being a recurring thing. Here are common causes for plugged ducts, and some things you can do to address them.

You went too long between feedings. Did you have family over to meet the new baby and were busy playing host? Was there a sudden change in your nursing pattern? Maybe baby started to sleep for longer stretches at night and your boobs didn’t get the memo.

The breast isn’t being emptied enough when nursing. Make sure to let baby fully drain one breast before starting on the other side. If baby gets full or falls asleep before draining a breast, start the next nursing session on that same side. Be careful not to cut nursing sessions short. Poor latch and positioning can also cause the breast to not get fully drained - Is baby tummy-to-tummy with you, with a deep latch every time?

You’re wearing an underwire bra or restrictive clothing. If you’re still wearing a bra with underwire, it’s time to stop. You may never go back :).

Breastmilk over-production

  • If over-production is causing too much milk, Sage Tea or Tincture can help decrease and moderate your supply. It’s would be best to talk with a lactation consultant before trying this though, as it can be overdone and you don’t want to decrease your supply too much.

What to do?

Most plugged ducts can be resolved at home within 1-2 days. The key is to draw out the milk from the plugged area completely and often, by any means possible.

  • Nurse often and fully drain the affected breast at each session. 

    • Nurse on the affected breast first as baby’s sucking is strongest at the start of a nursing session.

    • If baby doesn’t fully drain the affected breast during a nursing session, it’s okay to pump that side afterwards until it’s drained or softened.

    • If nursing is too painful on the affected breast, pump to drain that side every 3 hours for no more than 20 minutes at a time.

  • Switch up baby’s position when nursing

    • Have baby nurse with their chin pointing toward the tender area to help the duct fully drain.

    • Dangle nurse by hovering above baby on your hands and knees. This lets gravity help clear the blockage, and is especially helpful if your plugged duct is on the lower half of your breast. 

  • Gently massage the clog, especially before and after nursing

    • Massage toward your nipple to encourage milk to flow out. 

    • Use small circular motions to stimulate the plugged area. 

    • Avoid squeezing or pinching the lump. 

    • Bend over while massaging so breasts dangle. This can really help you “get at” a clog better, especially if it’s on the lower half of your breast.

    • Watch this video

  • Use heat and massage before nursing. This will soften or “melt” the plug and help it flow out.

    • Hot shower is the best option, because you can massage while applying heat 

    • A heating pad or hot water bottle works too.

  • Apply castor oil compress with heat for 20 minutes twice per day until plugged duct is gone. Some tips:

    • To make the compress: Saturate a piece of flannel with castor oil and place it on top of the affected area on your breast. Immediately cover the flannel with cling wrap (or other plastic sheeting) so the castor oil can’t get on anything besides your skin. Then apply heat on top of that (with an electric heating pad, hot water bottle, etc) for 20 minutes. When the time is up, store the oily flannel in the plastic bag it came in for next time. Then hop in the hot shower to wash off the castor oil and massage your breast. Castor oil can also cause diarrhea, so be sure its washed off thoroughly before putting baby to the breast.

    • Castor oil stains! So take off your top when working with it. If it does get on your clothes, don’t wash with other clothes as the castor oil will spread to them and ruin your favorite sweatshirt. 

  • Strengthen your immune system. Rest, reduce stress, eat nourishing foods and drink plenty of water. Some moms choose to herbally boost their immune system to help prevent infection if they know they are prone to mastitis (vitamin C, echinacea, elderberry are well-known immune system boosters). This supply of supplements is included in your kit.

  • Dress down. Wear loose-fitting clothing and no bra if possible (definitely no underwire).

  • If plugged ducts become a chronic issue for you, consider taking Sunflower Lecithin as a daily supplement to keep breast milk flowing smoothly and inhibit any more plugged ducts.

When to get help

Contact a lactation consultant or health care provider if:

  • Plugged duct does not resolve within 2 days

  • You have any questions

Want to talk with a lactation consultant?